Sickle cell disease in Bahia, Brazil: the social production of health policies and institutional neglect

A disease is considered neglected when it is not given due priority in health policies despite the social relevance of that disease, either in terms of the number of individuals affected by it or its morbidity or mortality. Although the causes are structural, neglect in health does not occur in a vacuum. In this paper, we explore how sickle cell disease (SCD) is constructed and neglected in Brazil, based on insights from our long-term participatory qualitative research in the state of Bahia. We present five overarching themes relevant to the social production of SCD, and associated health policies in Brazil: (1) The achievements and setbacks to overcome neglect in SCD, (2) Continuity of comprehensive SCD care; (3) Social movements of people with SCD; (4) Biocultural citizenship; and (5) Academic advocacy. We conclude that it is insufficient to merely recognize the health inequities that differentiate white and black populations in Brazil; racism must be understood as both a producer and a reproducer of this process of neglect. We conclude with a set of recommendations for the main SCD stakeholder groups committed to improving the lives of people living with SCD

Sickle Cell Disease in Bahia, Brazil: The Social Production of Health Policies and Institutional Neglect

A disease is considered neglected when it is not given due priority in health policies despite the social relevance of that disease, either in terms of the number of individuals affected by it or its morbidity or mortality. Although the causes are structural, neglect in health does not occur in a vacuum. In this paper, we explore how sickle cell disease (SCD) is constructed and neglected in Brazil, based on insights from our long-term participatory qualitative research in the state of Bahia. We present five overarching themes relevant to the social production of SCD, and associated health policies in Brazil: (1) The achievements and setbacks to overcome neglect in SCD, (2) Continuity of comprehensive SCD care; (3) Social movements of people with SCD; (4) Biocultural citizenship; and (5) Academic advocacy. We conclude that it is insufficient to merely recognize the health inequities that differentiate white and black populations in Brazil; racism must be understood as both a producer and a reproducer of this process of neglect. We conclude with a set of recommendations for the main SCD stakeholder groups committed to improving the lives of people living with SCD

A produção de massa dos sentidos: Cinema clássico como modernismo vernacular

Portuguese translation of Miriam Hansen's text, "The Mass Production of the Senses: Classical Cinema as Vernacular Modernism”, Modernism/Modernity, vol. 6, n. 2, 1999, pp. 59-77.Keywords: translation, Miriam Hansen, cinema and modernism, vernacular modernism.___________ La producción en masa de los sentidos: el cine clásico como modernismo vernacularResumen: Traducción al portugués del texto, originariamente en inglés, de Miriam Hansen, "The Mass Production of the Senses: Classical Cinema as Vernacular Modernism”, Modernism/Modernity, vol. 6, n. 2, 1999, pp. 59-77.Palabras clave: traducción, Miriam Hansen, cine y modernismo, modernismo vernacular.___________A produção de massa dos sentidos: cinema clássico como modernismo vernacular Resumo: Tradução para o português do texto em inglês de Miriam Hansen, "The Mass Production of the Senses: Classical Cinema as Vernacular Modernism”, Modernism/Modernity, vol. 6, n. 2, 1999, pp. 59-77.Palavras-chave: tradução, Miriam Hansen, cinema e modernismo, modernismo vernacular.___________  Date of reception: 21st August 2019  Date of acceptance: 29th November 2019Tradução para o português do texto em inglês de Miriam Hansen, "The Mass Production of the Senses: Classical Cinema as Vernacular Modernism”, Modernism/Modernity, vol. 6, n. 2, 1999, pp. 59-77.Palavras-chave: tradução, Miriam Hansen, cinema e modernismo, modernismo vernacular.___________La producción en masa de los sentidos: el cine clásico como modernismo vernacular Resumen: Traducción al portugués del texto, originariamente en inglés, de Miriam Hansen, "The Mass Production of the Senses: Classical Cinema as Vernacular Modernism”, Modernism/Modernity, vol. 6, n. 2, 1999, pp. 59-77.Palabras clave: traducción, Miriam Hansen, cine y modernismo, modernismo vernacular.___________ The Mass Production of the Senses: Classical Cinema as Vernacular ModernismAbstract: Portuguese translation of Miriam Hansen's text, "The Mass Production of the Senses: Classical Cinema as Vernacular Modernism”, Modernism/Modernity, vol. 6, n. 2, 1999, pp. 59-77.Keywords: translation, Miriam Hansen, cinema and modernism, vernacular modernism.___________ Data de recepção do artigo: 21 de Agosto de 2019   Data aceitação do artigo: 29 de Novembro de 2019

Electron Beam Size Measurements Using the Heterodyne Near Field Speckles at ALBA

Experiments using the heterodyne near field speckle method (HNFS) have been performed at ALBA to characterize the spatial coherence of the synchrotron radiation, with the ultimate goal of measuring both the horizontal and vertical electron beam sizes. The HNFS technique consists on the analysis of the interference between the radiation scattered by a colloidal suspension of nanoparticles and the synchrotron radiation, which in this case corresponds to the hard x-rays (12keV) produced by the in-vacuum undulator of the NCD-Sweet beamline. This paper describes the fundamentals of the technique, possible limitations, and shows the first experimental results changing the beam coupling of the storage ring

Intravenous infusions of glucose stimulate key lipogenic enzymes in adipose tissue of dairy cows in a dose-dependent manner

The present study was investigated whether increasing amounts of glucose supply have a stimulatory effect on the mRNA abundance and activity of key lipogenic enzymes in adipose tissue of midlactation dairy cows. Twelve Holstein-Friesian dairy cows in midlactation were cannulated in the jugular vein and infused with either a 40% glucose solution (n=6) or saline (n=6). For glucose infusion cows, the infusion dose increased by 1.25%/d relative to the initial net energy for lactation (NEL) requirement until a maximum dose equating to a surplus of 30% NEL was reached on d 24. This maximum dose was maintained until d 28 and stopped thereafter (between d 29-32). Cows in the saline infusion group received an equivalent volume of 0.9% saline solution. Samples of subcutaneous adipose tissue were taken on d 0, 8, 16, 24, and 32 when surplus glucose reached 0, 10, 20, and 30% of the NEL requirement, respectively. The mRNA abundance of fatty acid synthase, cytoplasmic acetyl- coenzyme A synthetase, cytoplasmic glycerol 3-phosphate dehydrogenase-1, and glucose 6-phosphate dehydrogenase showed linear treatment × dose interactions with increasing mRNA abundance with increasing glucose dose. The increased mRNA abundance was paralleled by a linear treatment × dose interaction for fatty acid synthase and acetyl-coenzyme A synthetase enzymatic activities. The mRNA abundance of ATP-citrate lyase showed a tendency for linear treatment × dose interaction with increasing mRNA abundance with increasing glucose dose. The mRNA abundance of all tested enzymes, as well as the activities of fatty acid synthase and acetyl-coenzyme A synthetase, correlated with plasma glucose and serum insulin levels. In a multiple regression model, the predictive value of insulin was dominant over that of glucose. In conclusion, gradual increases in glucose supply upregulate key lipogenic enzymes in adipose tissue of midlactating dairy cows with linear dose dependency. Insulin appears to be critically involved in this regulation. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved

Progress on transverse beam profile measurement using the heterodyne near field speckles method at Alba

We present the recent developments of a study aimed at measuring the transverse beam profile using the Heterodyne Near Field Speckles (HNFS) method. The HNFS technique works by illuminating a suspension of Brownian nanoparticles with synchrotron radiation and studying the resulting interference pattern. The transverse coherence of the source, and therefore, under the conditions of validity of the Van Cittert and Zernike theorem, the transverse electron beam size is retrieved from the interference between the transmitted beam and the spherical waves scattered by each nanoparticle. We here describe the fundamentals of this technique, as well as the recent experimental results obtained with 12 keV undulator radiation at the NCD beamline at the ALBA synchrotron. The applicability of such a technique for future accelerators (e.g. CLIC or FCC) is also discussed

Transoral incisionless fundoplication effective in eliminating GERD symptoms in partial responders to proton pump inhibitor therapy at 6 months: The TEMPO randomized clinical trial

Background. Incomplete control of troublesome regurgitation and extraesophageal manifestations of chronic gastroesophageal reflux disease (GERD) is a known limitation of proton pump inhibitor (PPI) therapy. This multicenter randomized study compared the efficacy of transoral incisionless fundoplication (TIF) against PPIs in controlling these symptoms in patients with small hiatal hernias. Methods. Between June and August 2012, 63 patients were randomized at 7 US community hospitals. Patients in the PPI group were placed on maximum standard dose (MSD). Patients in the TIF group underwent esophagogastric fundoplication using the EsophyX2 device. Primary outcome was elimination of daily troublesome regurgitation or extraesophageal symptoms. Secondary outcomes were normalization of esophageal acid exposure (EAE), PPI usage and healing of esophagitis. Results. Of 63 randomized patients (40 TIF and 23 PPI), 3 were lost to follow-up leaving 39 TIF and 21 PPI patients for analysis. At 6-month follow-up, troublesome regurgitation was eliminated in 97% of TIF patients versus 50% of PPI patients, relative risk (RR) = 1.9, 95% confidence interval (CI) = 1.2-3.11 (P = .006). Globally, 62% of TIF patients experienced elimination of regurgitation and extraesophageal symptoms versus 5% of PPI patients, RR = 12.9, 95% CI = 1.9-88.9 (P = .009). EAE was normalized in 54% of TIF patients (off PPIs) versus 52% of PPI patients (on MSD), RR = 1.0, 95% CI = 0.6-1.7 (P = .914). Ninety percent of TIF patients were off PPIs. Conclusion. At 6-month follow-up, TIF was more effective than MSD PPI therapy in eliminating troublesome regurgitation and extraesophageal symptoms of GERD

Community engagement in Cutaneous Leishmaniasis research in Brazil, Ethiopia, and Sri Lanka: A decolonial approach for global health.

Cutaneous leishmaniasis (CL) is a parasitic skin disease endemic in at least 88 countries where it presents an urgent, albeit often "neglected" public health problem. In this paper, we discuss our model of decolonial community engagement in the ECLIPSE global health research program, which aims to improve physical and mental health outcomes for people with CL. The ECLIPSE program has four interlinked phases and underpinning each of these phases is sustained and robust community engagement and involvement that guides and informs all activities in ECLIPSE. Our decolonial approach implies that the model for community engagement will be different in Brazil, Ethiopia and Sri Lanka. Indeed, we adopt a critical anthropological approach to engaging with community members and it is precisely this approach we evaluate in this paper. The data and material we draw on were collected through qualitative research methods during community engagement activities. We established 13 Community Advisory Groups (CAGs): in Brazil ( = 4), Ethiopia ( = 6), and Sri Lanka ( = 3). We identified four overarching themes during a thematic analysis of the data set: (1) Establishing community advisory groups, (2) CAG membership and community representation, (3) Culturally appropriate and context-bespoke engagement, and (4) Relationships between researchers and community members. During our first period of ECLIPSE community engagement, we have debunked myths (for instance about communities being "disempowered"), critiqued our own practices (changing approaches in bringing together CAG members) and celebrated successes (notably fruitful online engagement during a challenging COVID-19 pandemic context). Our evaluation revealed a gap between the exemplary community engagement frameworks available in the literature and the messy, everyday reality of working in communities. In the ECLIPSE program, we have translated ideal(istic) principles espoused by such community engagement guidance into the practical realities of "doing engagement" in low-resourced communities. Our community engagement was underpinned by such ideal principles, but adapted to local sociocultural contexts, working within certain funding and regulatory constraints imposed on researchers. We conclude with a set of lessons learned and recommendations for the conduct of decolonial community engagement in global health research. [Abstract copyright: Copyright © 2022 Polidano, Parton, Agampodi, Agampodi, Haileselassie, Lalani, Mota, Price, Rodrigues, Tafere, Trad, Zerihun and Dikomitis.

The TEMPO Trial at 5 Years: Transoral Fundoplication (TIF 2.0) Is Safe, Durable, and Cost-effective.

BACKGROUND: Questions remain about the therapeutic durability of transoral incisionless fundoplication (TIF). In this study, clinical outcomes were evaluated at 5 years post-TIF 2.0. METHODS: A total of 63 chronic gastroesophageal reflux disease (GERD) sufferers with troublesome symptoms refractory to proton pump inhibitor (PPI) therapy, absent or ≤2 cm hiatal hernia, and abnormal esophageal acid exposure were randomized to the TIF group or PPI group. Following the 6-month evaluation, all patients in the PPI group elected for crossover to TIF; therefore, all 63 patients underwent TIF 2.0 with EsophyX RESULTS: Of 63 patients, 60 were available at 1 year, 52 at 3 years, and 44 at 5 years for evaluation. Troublesome regurgitation was eliminated in 88% of patients at 1 year, 90% at 3 years, and 86% at 5 years. Resolution of troublesome atypical symptoms was achieved in 82% of patients at 1 year, 88% at 3 years, and 80% at 5 years. No serious adverse events occurred. There were 3 reoperations by the end of the 5-year follow-up. At the 5-year follow-up, 34% of patients were on daily PPI therapy as compared with 100% of patients at screening. The total GERD Health-related quality-of-life score improved by decreasing from 22.2 to 6.8 at 5 years ( P \u3c .001). CONCLUSION: In this patient population, the TIF 2.0 procedure provided safe and sustained long-term elimination of troublesome GERD symptoms